Uterine artery embolization vs hysterectomy in the treatment of symptomatic uterine fibroids: 5-year outcome from the randomized EMMY trial

Am J Obstet Gynecol. 2010 Aug;203(2):105.e1-13. doi: 10.1016/j.ajog.2010.01.049. Epub 2010 Jul 1.

Abstract

Objective: The purpose of this study was to compare clinical outcome and health related quality of life (HRQOL) 5 years after uterine artery embolization (UAE) or hysterectomy in the treatment of menorrhagia caused by uterine fibroids.

Study design: Patients with symptomatic uterine fibroids who were eligible for hysterectomy were assigned randomly 1:1 to hysterectomy or UAE. Endpoints after 5 years were reintervention rates, menorrhagia, and HRQOL measures that were assessed by validated questionnaires.

Results: Patients were assigned randomly to UAE (n = 88) or hysterectomy (n = 89). Five years after treatment 23 of 81 UAE patients (28.4%) had undergone a hysterectomy because of insufficient improvement of complaints (24.7% after successful UAE). HRQOL measures improved significantly and remained stable until the 5-year follow-up evaluation, with no differences between the groups. UAE had a positive effect both on urinary and defecation function.

Conclusion: UAE is a well-established alternative to hysterectomy about which patients should be counseled.

Publication types

  • Comparative Study
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Female
  • Follow-Up Studies
  • Humans
  • Hysterectomy / adverse effects
  • Hysterectomy / methods*
  • Hysterectomy, Vaginal / adverse effects
  • Hysterectomy, Vaginal / methods
  • Kaplan-Meier Estimate
  • Leiomyoma / pathology
  • Leiomyoma / surgery*
  • Middle Aged
  • Neoplasm Staging
  • Pain Measurement
  • Pain, Postoperative / physiopathology
  • Patient Satisfaction
  • Postoperative Complications / epidemiology
  • Postoperative Complications / physiopathology
  • Prospective Studies
  • Quality of Life*
  • Risk Assessment
  • Statistics, Nonparametric
  • Time Factors
  • Treatment Outcome
  • Uterine Artery Embolization / adverse effects
  • Uterine Artery Embolization / methods*
  • Uterine Neoplasms / pathology
  • Uterine Neoplasms / surgery*